Individual provider Active NPI

Jennifer L Anthony, PT

  • Physical Therapist
  • Bolingbrook, IL
National Provider Identifier
1205067592
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.024920 Issued in IL
Practice address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone
(412) 394-2800
NPI assigned
Aug 4, 2009
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009566 OH
Physical Therapist 225100000X 070.024920 IL Primary

Addresses

Primary practice location

790 Remington Blvd
Bolingbrook, IL 60440-4909

Mailing address

208 Doud Dr
Normal, IL 61761-3212
Phone (614) 266-6948

Other practice location 1

1800 Riverside Drive
Columbus, OH 43212
Phone (614) 486-9511 ext. 236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211007001391 IL Practitioner - Physical Therapist in Private Practice 0941608871 Reassigns benefits to 1 organization
I20250122000210 AR Practitioner - Physical Therapist in Private Practice 0941608871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.61 of 100Reported as group
Quality
90
Improvement activities
40
Cost
70.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.024920ILMDPhysical Therapist
PT009566OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients
Brookfield Physical Rehabilitation, LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

1806 N Market St
Champaign, IL 61822
Phone (217) 356-4920

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1205067592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 DOUD DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613212",
            "telephone_number": "614-266-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "412-394-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Riverside Drive",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43212",
            "country_code": "US",
            "telephone_number": "614-486-9511 x236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT009566",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.